The Orthopedic Department, Odense University Hospital.
Department of Clinical Medicine, University of Southern Denmark.
Dan Med J. 2024 Feb 15;71(3):A10220636. doi: 10.61409/A10220636.
This retrospective cohort study aimed to examine whether implementing mandatory referral changed the composition of patients visiting the Accident and Emergency (A and E) Department in relation to severity, demographics and activity at injury.
Patients visiting the A and E Department at Odense University Hospital, Denmark, in 2008-2019, were divided into three time periods: before (four years before any changes in the operation of the A and E), transition period (the four years during which mandatory referral and the centralised emergency medical service were implemented) and after (the four years after these changes had been implemented). The incidence rate ratios and odds were calculated.
The absolute number of severe injuries declined, but to a lesser extent than the number of minor injuries. The incidence rate ratios throughout all subcategories, including severity, fracture, sex, age and activity at injury, indicate a smaller risk of visiting the A and E Department in the after period than in the before period, with a total lower (0.82 times; 95% confidence interval: 0.82-0.83 times) risk of visiting the A and E Department in the after period than in the before period.
Changing from open to referred access altered the composition of injuries for patients seen in the A and E Department, indicating a smaller risk of a visit with referred access than with open access. The odds of a visit being due to a major injury increased after implementing referred access, and the number of visits decreased.
The Nordentoft Fund TRIAL REGISTRATION. Not relevant.
本回顾性队列研究旨在探讨实施强制性转诊是否改变了急诊科就诊患者的严重程度、人口统计学特征和受伤时的活动情况。
丹麦欧登塞大学医院急诊科 2008-2019 年就诊的患者分为三个时间段：前（任何改变急诊科运营之前的四年）、过渡期（实施强制性转诊和集中急救服务的四年）和后（这些变化实施后的四年）。计算发病率比值和比值比。
严重损伤的绝对数量有所下降，但下降幅度小于轻伤数量。所有亚类别的发病率比值，包括严重程度、骨折、性别、年龄和受伤时的活动情况，都表明在后时期就诊急诊科的风险较小，在后时期就诊急诊科的总风险（0.82 倍；95%置信区间：0.82-0.83 倍）低于前时期。
从开放通道改为转诊通道改变了急诊科就诊患者的损伤构成，表明转诊通道就诊的风险小于开放通道就诊。实施转诊后，因重大损伤就诊的几率增加，就诊次数减少。
Nordentoft 基金
不相关。
